A dual aligner assembly including a plurality of aligners, including a first aligner and a second aligner. The first aligner has a first shape corresponding to a set of target tooth positions and applies an orthodontic force against a set of target teeth. The first orthodontic force generates movement of the set of target teeth to the set of target tooth positions. The second aligner has a second shape corresponding to a combination of current tooth positions of the set of target teeth, the set of target tooth positions, and a thickness of the first aligner. The second aligner partially encloses the first aligner and provides an anchor for at least a portion of the first aligner. Via the anchor, a combination of the first aligner and the second aligner provides an orthodontic force that prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment.
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9. A multi-aligner assembly comprising:
a first aligner having a first rigidity, the first aligner comprising tooth cavities having a first shape corresponding to a set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of at least three adjacent target teeth of a plurality of teeth of a dental arch of a patient, wherein said first orthodontic force generates movement of said set of at least three adjacent target teeth from a set of current tooth positions toward said set of target tooth positions through a desired treatment movement pathway;
a second aligner having a second rigidity greater than said first rigidity, said second aligner configured to at least partially enclose the first aligner and envelope said set of at least three adjacent target teeth in said set of current tooth positions, said set of target tooth positions, or a set of planned positions representing planned treatment movement to achieve said set of target tooth positions from said set of current tooth positions, wherein said second aligner is configured to anchor at least a portion of the first aligner, wherein via said anchoring, a combination of the first aligner and said second aligner create one or more controlled forces to move said set of at least three adjacent target teeth toward said set of target tooth positions through the desired treatment movement pathway and the first aligner comprises a first force enlargement element extending outwards and away from a cavity corresponding to an inner tooth between outer teeth of said set of at least three adjacent target teeth, such that when the multi-aligner assembly is snapped over the plurality of teeth and said second aligner is snapped over the first aligner, said second aligner contacts and presses against the first force enlargement element and thereby is configured to increase said first orthodontic force against the inner tooth of said set of at least three adjacent target teeth.
13. A multi-aligner assembly comprising:
a first aligner having a first rigidity, the first aligner further comprising tooth cavities having a first shape corresponding to a set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of at least three adjacent target teeth of a plurality of teeth of a dental arch of a patient, wherein said first orthodontic force generates movement of said set of at least three adjacent target teeth from a set of current tooth positions toward said set of target tooth positions through a desired treatment movement pathway; and
a second aligner having a second rigidity greater than said first rigidity, said second aligner configured to at least partially enclose the first aligner and envelope said set of at least three adjacent target teeth in said set of current tooth positions, said set of at least three adjacent target teeth in said set of target tooth positions, and said set of at least three adjacent target teeth in a set of planned positions representing planned treatment movement to achieve said set of target tooth positions from said set of current tooth positions, wherein said second aligner comprises means for anchoring at least a portion of the first aligner, wherein via said means for anchoring, a combination of the first aligner and said second aligner create one or more controlled forces to move said set of at least three adjacent target teeth toward said set of target tooth positions through said desired treatment movement pathway and the first aligner comprises a first force enlargement element extending outwards and away from a cavity corresponding to an inner tooth between outer teeth of said set of at least three adjacent target teeth, such that when the multi-aligner assembly is snapped over the plurality of teeth and said second aligner is snapped over the first aligner, said second aligner contacts and presses against the first force enlargement element and thereby is configured to increase said first orthodontic force against the inner tooth of said set of at least three adjacent teeth.
1. A multi-aligner assembly comprising:
a plurality of aligners, wherein said plurality of aligners comprises:
a first aligner comprising a first material having a first rigidity, the first aligner further comprising tooth cavities having a first shape corresponding to a set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of at least three adjacent target teeth of a plurality of teeth of a dental arch of a patient, wherein said first orthodontic force generates movement of said set of at least three adjacent target teeth from a set of current tooth positions toward said set of target tooth positions through a desired treatment movement pathway; and
a second aligner comprising a second material having a second rigidity greater than said first rigidity, said second aligner configured to at least partially enclose the first aligner and envelope said set of at least three adjacent target teeth in said set of current tooth positions, said set of target tooth positions, or a set of planned positions representing planned treatment movement to achieve said set of target tooth positions from said set of current tooth positions, wherein said second aligner is configured to anchor at least a portion of the first aligner, wherein via said anchoring, a combination of the first aligner and said second aligner create one or more controlled forces to move said set of at least three adjacent target teeth toward said set of target tooth positions through said desired treatment movement pathway and the first aligner comprises a first force enlargement element extending outwards and away from a cavity corresponding to an inner tooth between outer teeth of said set of at least three adjacent target teeth, such that when the multi-aligner assembly is snapped over the plurality of teeth and said second aligner is snapped over the first aligner, said second aligner contacts and presses against the first force enlargement element and thereby is configured to increase said first orthodontic force against the inner tooth of said set of at least three adjacent target teeth.
2. The multi-aligner assembly of
3. The multi-aligner assembly of
4. The multi-aligner assembly of
5. The multi-aligner assembly of
6. The multi-aligner assembly of
7. The multi-aligner assembly of
a second force enlargement element extending into a gap between the first aligner and said second aligner, and wherein a second gap provides an area into which a movement of at least one tooth of said set of at least three adjacent target teeth to at least one target tooth position of said set of target tooth positions is accomplished.
8. The multi-aligner assembly of
10. The multi-aligner assembly of
11. The multi-aligner assembly of
12. The multi-aligner assembly of
14. The multi-aligner assembly of
15. The multi-aligner assembly of
16. The multi-aligner assembly of
17. The multi-layer assembly of
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This application claims priority to and benefit of U.S. Patent Application No. 62/189,384 filed on Jul. 7, 2015 entitled “DUAL ALIGNER ASSEMBLY” by Wu et al., and assigned to the assignee of the present application.
The subject matter of the following patent applications is related to the present application: U.S. application Ser. No. 15/202,342, filed Jul. 5, 2016, entitled “MULTI-MATERIAL ALIGNERS”, which claims the benefit of U.S. Provisional Application No. 62/189,259, filed Jul. 7, 2015, and U.S. Provisional Application No. 62/189,282, filed Jul. 7, 2015.
All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference.
This invention relates in general to a system of repositioning teeth for use in orthodontic treatment. More particularly, this invention relates to the use of orthodontic appliances for producing tooth movements.
Orthodontic treatments involve repositioning misaligned teeth and improving bite configurations for improved cosmetic appearance and dental function. Repositioning teeth is accomplished by applying controlled forces to the teeth over an extended period of time. This is conventionally accomplished by wearing what are commonly referred to as “braces”. Braces comprise a variety of appliances such as brackets, bands, archwires, ligatures, and O-rings. After they are bonded to the teeth, periodic meetings with the orthodontist are required to adjust the braces. This involves installing different archwires having different force-inducing properties or by replacing or tightening existing ligatures. Between meetings, the patient may be required to wear supplementary appliances, such as elastic bands or headgear, to supply additional or extraoral forces.
Although conventional braces are effective, they are often a tedious and time consuming process requiring many visits to the orthodontist's office. Moreover, from a patient's perspective, they are unsightly and uncomfortable. Consequently, alternative orthodontic treatments have been developed. A particularly promising approach relies on the use of elastic positioning appliances for realigning teeth. Such appliances comprise a thin shell of elastic material that generally conforms to a patient's teeth but is slightly out of alignment with the initial tooth configuration. Placement of the elastic positioner over the teeth applies controlled forces in specific locations to gradually move the teeth into the new configuration. Repetition of this process with successive appliances comprising new configurations eventually moves the teeth through a series of intermediate configurations to a final desired configuration. A full description of an exemplary elastic polymeric positioning appliance is described in U.S. Pat. No. 5,975,873, assigned to the assignee of the present invention, and incorporated by reference for all purposes.
In addition to their ease of use, polymeric positioning appliances are generally transparent, providing an improved cosmetic appearance, and impart substantial force on the teeth, due to stiffness of the appliance. Each aligner shell has an inner shape that is configured to move the patient's teeth to the next planned position. However, when a patient's teeth do not follow this planned movement by not moving or moving in an unplanned direction, a “lag of movement” occurs. When this lag of movement becomes too great, that is, when the difference between the current position of the patient's teeth and the planned position at which the aligner is to move the teeth becomes too great, in many cases, the aligner is no longer able to be snapped onto the patient's teeth. Accordingly, improved appliances and techniques are needed to reduce this lag in movement during orthodontic treatment, and to reduce unwanted tooth movements.
Aspects of the present invention are illustrated by way of example, and not by way of limitation, in the accompanying drawings, wherein:
The drawings referred to in this description should be understood as not being drawn to scale except if specifically noted.
In one embodiment, a dual aligner assembly includes a plurality of aligners. The plurality of aligners includes a first aligner and a second aligner. The first aligner includes a first material having a first shape corresponding to a set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of target teeth of a plurality of teeth of a dental arch of a patient, wherein the first orthodontic force generates movement of the set of target teeth to the set of target tooth positions. The second aligner includes a second material having a second shape corresponding to a combination of current tooth positions of the set of target teeth, the set of target tooth positions, and a thickness of the first aligner, wherein the second aligner partially encloses the first aligner and provides an anchor for at least a portion of the first aligner, wherein via the anchor, a combination of the first aligner and the second aligner provides added support for the accurate movement of the target teeth to the set of target tooth positions via the first orthodontic force and prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment.
In one embodiment, the first aligner is an inner aligner that is partially enclosed by an outer aligner. In another embodiment, the second aligner is an outer aligner that partially encloses an inner aligner. In yet another embodiment, the second aligner is an inner aligner that is partially enclosed by a third aligner.
In one embodiment, the unwanted tooth positions include tooth positions other than the following tooth positions: the current tooth positions of the set of target teeth; one or more tooth positions that represent movement of at least one tooth of the set of target teeth to the set of target tooth positions; and the set of target tooth positions.
In one embodiment, the second aligner is more rigid than the first aligner. In one embodiment, the second aligner is less rigid than the first aligner. In one embodiment, the second aligner is equal in rigidity to the first aligner.
In one embodiment, the first aligner includes: a first force enlargement element. The first force enlargement element includes: a contact region between the first aligner and the second aligner, wherein the contact region provides an anchor point at the second aligner and for the first aligner, whereby the first orthodontic force, via the anchor point and by the first aligner, is increased against at least one tooth of the set of target teeth.
In one embodiment, the first force enlargement element includes a dimple. In another embodiment, the first force enlargement element includes a ridge. In yet another embodiment, the first force enlargement element includes an outward protrusion. A dimple and a ridge, in some instances, are formed to be outward protrusions.
In one embodiment, the dual aligner assembly includes a second force enlargement element. The second force enlargement element includes: a non-contact region between the first aligner and the second aligner, wherein the non-contact region provides an area into which a movement of at least one tooth of the set of target teeth to at least one target tooth position of the set of target tooth positions is accomplished. In one embodiment that includes the second force enlargement element, the first aligner includes a dimple. In another embodiment that includes the second force enlargement element, the first aligner includes a ridge. In yet another embodiment that includes the second force enlargement element, the first aligner includes an outward protrusion.
In one embodiment, the plurality of aligners further includes: a third aligner that includes a second material having a third shape corresponding to a combination of the current tooth positions of the set of target teeth, the set of target tooth positions and a thickness of the second aligner, wherein the third aligner partially encloses the second aligner and provides an anchor for at least a portion of the second aligner, wherein via the anchor, a combination of the first aligner, the second aligner and the third aligner provides a third orthodontic force that prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment. In one embodiment, including the third aligner, the unwanted tooth positions include tooth positions other than the following tooth positions: the current tooth positions of the set of target teeth; one or more tooth positions that represent movement of at least one tooth of the set of target teeth to the set of target tooth positions; and the set of target tooth positions.
In one embodiment, the third aligner is an inner aligner that is partially enclosed by an outer aligner. In another embodiment, the third aligner is an outer aligner that partially encloses an inner aligner. In yet another embodiment, the third aligner is an inner aligner that is partially enclosed by a fourth aligner. Of note, the fourth aligner, in one embodiment, includes the features described herein in relation to the third aligner, except that the fourth aligner also accommodates not only the features of the first and second aligner, but also accommodates the features of the third aligner.
In one embodiment, a dual aligner assembly includes: a plurality of aligners. The plurality of aligners includes a first aligner and a second aligner. The first aligner includes a first material having a first shape corresponding to a first set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of target teeth of a plurality of teeth of a dental arch of a patient, wherein the first orthodontic force generates movement of the set of target teeth to the first set of target tooth positions. The second aligner includes a second material having a second shape corresponding to a combination of current tooth positions of the set of target teeth, the first set of target tooth positions, at least a second set of target tooth positions, and a thickness of at least the first aligner. The second aligner partially encloses the at least first aligner and provides an anchor for at least a portion of the at least first aligner. Via the anchor, a combination of the first aligner and the second aligner and any intermediate aligner positioned between the first aligner and the second aligner provides added support for the movement of the target teeth to the set of target tooth positions and provides a second orthodontic force that prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment.
The detailed description set forth below in connection with the appended drawings is intended as a description of various embodiments of the present invention and is not intended to represent the only embodiments in which the present invention may be practiced. Each embodiment described in this disclosure is provided merely as an example or illustration of the present invention, and should not necessarily be construed as preferred or advantageous over other embodiments. In some instances, well known methods, procedures, objects, and circuits have not been described in detail as not to unnecessarily obscure aspects of the present disclosure.
Overview of Discussion
Embodiments disclosed herein include a dual aligner assembly for moving teeth to a desired position. For example, the dual aligner assembly includes an outer aligner, and at least one inner aligner. The inner aligner(s) is formed based on the patient's teeth position in the next stage. In one embodiment, the inner aligner(s) is made of soft and thin polymeric film. The outer aligner is formed based on the combination of the current position and the “next” position of the patient's teeth, as well as the thickness of the inner aligner(s). In one embodiment, the outer aligner is made of hard and thick polymeric film. (It should be noted that in various embodiments, the inner and outer aligner may be composed of material having more, less, or the same amount of rigidity.) The outer aligner functions as anchorage for the inner aligner(s), enabling the inner aligner(s) to move the patient's teeth to desired positions with larger and more accurate forces than enabled by conventional aligner systems.
The dual aligner assembly, in various embodiments, includes protrusions (e.g., dimples, ridges) that increase the engagement between the outer aligner and the inner aligner(s), thereby providing even greater anchorage support to the inner aligner(s). For example, dimples and/or ridges may be formed in the inner aligner and fill a portion of the gap between the outer aligner and the inner aligner(s) or between multiple inner aligners. These dimples and/or ridges aid in creating more accurate forces near the patient's gingival line to move the patient's teeth to the desired teeth positions.
Thus, embodiments enable an increase of force that may be applied by the inner surface of the most inner aligner against a patient's tooth or teeth in order to move the patient's teeth to desired tooth positions. Using this novel technology, difficult tooth movement may be accomplished, such as posterior arch expansion, pure translation and multiple teeth extrusion. For example, a multiple anterior tooth extrusion may be performed to fix a patient's open bit, a posterior distalization may be performed to create space in order to resolve spacing issues in a patient's bit, and a patient's posterior cross bite or scissor bite may be fixed by moving a patient's molar faster than would be accomplished with conventional technology. Of note, the embodiments described herein may be applied to achieve any type of tooth movement, in any direction, in any arbitrary plane of space.
The discussion begins with a description of a conventional aligner system. Continuing, the discussion turns to a description of embodiments of a novel dual aligner assembly, according to various embodiments.
Conventional Aligner System
Conventional aligner systems are used to treat thousands of mild and moderately difficult orthodontic cases each month. Conventional aligner systems include many technological improvements that improve the predictability and performance of the product, thereby also enabling the conventional aligner system to treat more difficult orthodontic cases.
For example, such technological improvements include optimized attachments, power ridges, and rubber bands. Some optimized attachments are shown to improve the rotation of premolars and canines to fix severe crowding, while other optimized (extrusion) attachments are shown to extrude anterior incisors to fix an open bite. The power ridge technology is shown to move the root lingually, to improve the clinical profile of an upper jaw. The rubber band technology is shown to help A/P movement (NP class correction). Even given the latest technological improvements, there currently exist many limitations to aligner systems.
In the conventional aligner system, the tooth's initial position is acquired from the patient's initial impression without treatment. The treatment goal is set up by the software and/or the user as the final desired position. Between the tooth's initial position and the tooth's final position, some intermediate positions are created through tooth path planning and can be assigned the symbols i (tooth's initial position) and i+1 (an intermediate position). To achieve the movement from i to i+1, the patient wears the aligner that is manufactured based on the position i+1.
One major problem with the conventional aligner system is the lack of predictability of tooth movement, such as when teeth do not follow the planned tooth movement from i to i+1 and when the lag of the movement from i to i+1 is too large. When the lag is too large, the difference between the current teeth position and the aligner is also too large so that the aligner cannot be snapped onto the teeth anymore. When this situation occurs, the planned treatment has to be restarted (“middle course correction”), the remaining manufactured aligners are wasted, and the required treatment time is extended.
One of the causes of the movement lag is that the force from the aligner is too small or not in the correct direction of the desired tooth movement. The aligner itself is plastic and is in the shape of teeth, and the force created by the aligner placed on the teeth comes from the deformation of the plastic shell of the aligner. The deformation is caused by the patient's teeth pushing against the plastic shell. In general, the conventional aligner is more rigid near the incisal edge of the patient's tooth and is weaker near the gingival line of the patient's tooth. Thus, the same deformation created by the patient's teeth pushing against the plastic shell at the gingival line will produce less force than the patient's teeth pushing against the plastic shell at the incisal edge. Additionally, when the plastic shell is deformed near one tooth at the gingival line, the plastic shell opens up and it is possible that the plastic shell does not touch nearby teeth near the gingival line.
Yet another problem with conventional aligners involves the group movement of teeth, such as when all the teeth are moved in the same direction. For example, when performing an arch expansion procedure, the patient's posterior teeth are moved as a group in the buccal direction. In this situation, there is only deformation between the posterior teeth and other teeth. No force is created inside the group of posterior teeth. Thus, only the boundary teeth of this group of posterior teeth can be moved, while other teeth may still remain in the initial tooth position. This problem can be solved by moving each tooth of the group of posterior teeth one by one. However, moving teeth one by one requires more treatment time and requires more aligners to be manufactured, thereby increasing the treatment costs.
The novel dual aligner assembly, according to embodiments and as will be described herein, resolve at least the foregoing issues. In one embodiment, the dual aligner assembly includes the following structural features:
1) An inner aligner that is softer and thinner than the outer aligner. The inner aligner is manufactured based on the teeth position of the next stage (e.g., i+1). The inner aligner is used to create small and constant orthodontic force to move the teeth. Of note, while the term, “inner aligner” is used most often herein to discuss the structural features of the dual aligner assembly, the term “first aligner” is also used to describe the inner aligner, according to one embodiment.
(In another embodiment however, the term inner aligner is used to refer to an aligner that is manufactured based on the teeth position of any position of a stage of treatment that comes after the teeth position of the next stage, such as i+1+n where n is any stage of treatment after the treatment stage that follows the current position of the teeth.)
2) The outer aligner is stronger and thicker than the inner aligner. The outer aligner is big enough to hold the inner aligner. The inner aligner is able to anchor onto the outer aligner and use the outer aligner as support to provide larger and more accurate forces against the patient's teeth as the patient's teeth deform the inner aligner. Of note, while the dual aligner assembly is most often discussed herein in terms of “outer aligner”
3) The outer aligner is large enough to hold the teeth position from the initial position, i, to the next position, i+1, such that there is not extract force if the patient's teeth movement follow the planned movement treatment.
4) Features, such as dimples and/or ridges, may be added to the inner aligner to push the teeth. Dimples and/or ridges may be added to the outer aligner to create larger and more accurate forces to push the patient's teeth toward the next position, i+1.
Of note, while the dual aligner assembly is described in general with reference to an inner aligner and an outer aligner, it should be understood that the dual aligner assembly may include multiple inner aligners, each inner aligner capable of including the features described below. Further, while the dual aligner assembly is described in general with reference to an outer aligner being of a more rigid composition than the inner aligner, it should be understood that the dual aligner assembly may function as intended with an outer aligner being of a less rigid composition or of a composition with an equivalent rigidity compared to the inner aligner(s), in accordance with an embodiment.
The following is a brief description of at least some of the advantages and the benefits resulting from implementation of various embodiments of the dual aligner assembly, as will be described herein.
1) Increased Control of Gingival Force and Root Movement: When the dual aligner assembly is snapped onto the patient's teeth, and the patient's teeth push against the inner surface of the inner aligner, the inner aligner deforms and opens up. Portions of this deformation, on the outer surface of the inner aligner, push against the inner surface of the outer aligner. Since, in some embodiments, the outer aligner is more rigid than the inner aligner, the pushing of the patient's teeth against the inner aligner does not easily cause the outer aligner to also deform and open up. Since the outer aligner has a greater rigidity than the inner aligner, in response to the inner aligner pushing against the outer aligner due to the deformation, the outer aligner pushes back against the inner aligner with a designated force that causes the inner aligner to press against the patient's teeth to effect a planned movement treatment of the patient's teeth to the desired position.
For example, since the outer aligner is stronger and more rigid than the inner aligner near the gingival line, the pressing of the outer aligner against the inner aligner causes the force with which the inner surface of the inner aligner presses against the patient's teeth to be increased at the gingival line. Whereas, without the dual aligner assembly, the conventional aligner would open up at the gingival line and not be able to create the necessary force to press against the gingival line of the patient's teeth; the novel dual aligner assembly described herein provides a force for applying pressure against the patient's teeth in a planned movement treatment.
2) Increased Control of Group Movement and Posterior Expansion: In various embodiments of the dual aligner assembly, the inner aligner includes at least one dimple and/or ridge (as will be explained below with reference to
3) Increased Control of Rotation of Premolar and Canine Teeth: In various embodiment of the dual aligner assembly, the more rigid outer aligner holds the inner aligner close to the patient's teeth, such that the inner aligner pushes the patient's teeth in a tangent direction, thereby creating rotation torque (as will be explained below with reference to
4) Increased Guidance and Predictability of Tooth Movement: In various embodiments of the dual aligner assembly, while the inner aligner generates force (via engagement with the outer aligner at predetermined positions) to achieve the planned tooth movement, the outer aligner provides tooth movement guidance. This will provide extra guidance for movement of the patient's teeth, compared to conventional aligners, thereby making the patient's tooth movement more predictable.
5) Increased Compliance with a Tooth's Biological Response: According to various embodiments wherein the inner aligner is softer and thinner than the outer aligner and the outer aligner is larger than the inner aligner, the dual aligner design creates more flexibility with regard to design, thereby enabling the patient's biological response to the treatment to comply with the patient's natural tooth movement.
The inner aligner 106 is the aligner that is positioned to be closer to the patient's teeth 102. The inner aligner 106 is designed and manufactured to hold the patient's teeth 102 in the desired next position (e.g., i+1). In one embodiment, the inner aligner 106 is made of a soft and thin plastic film and delivers small and constant orthodontic force to the patient's teeth 102 at predetermined contact points, such as at contact region one 108 and contact region two 116. The shape of the inner aligner 106 is the shape of all of the patient's teeth 102 posited in the next position of treatment, i+1, such as the target tooth position 114.
The outer aligner 104 partially encloses the inner aligner 106 and is designed to hold the inner aligner 106 and to hold the patient's tooth 120 in either the tooth's current position 110 or the target tooth position 114, or any tooth position representing planned treatment movement to achieve the target tooth position 114 from the tooth's current position 110. The outer aligner 104 is made of hard or thick plastic film and provides anchorage for the inner aligner 106. The shape of the outer aligner 104 is the shape of the combined shapes of the patient's teeth 102 in their current position 110 and patient's teeth 102 in the target tooth position 114. The shape of the outer aligner 104 also accommodates the thickness of the inner aligner 106.
Thus, if the patient's tooth 102 is moving to the target teeth position 114, i+1, then the outer aligner 104 does not create any extract forces against the patient's tooth 120 (or teeth). However, if the patient's tooth 102 is even slightly wavering (moving away) from the determined movement pathway from the tooth's current position 110, i, to the target teeth position 114, i+1, then the outer aligner 104 presses against the inner aligner 106, thereby creating an extracting force against the patient's tooth 120 that is wavering from the desired treatment movement pathway. Of note, the description herein regarding the dual aligner assembly 100 is described in terms of the patient's tooth 120 for the purposes of brevity and clarity in explanation, but it should be understood that the same principals described herein may be applied to more than one tooth of the patient's plurality of teeth 102.
Next, the potential contact region 126 near the patient's second tooth 124 will be discussed. If the dual aligner assembly 100 is designed such that the patient's second tooth 124 moves and contacts the inner aligner 106 within the potential contact region 126, the outer aligner 104 will prevent the inner aligner 106 from stretching outward much further (if any further), thereby substantially stopping the outward stretching of the inner aligner, and therefore keep the patient's second tooth 124 within a certain predetermined distance from its original position. Thus, even though the movement of one tooth or the pressure applied by the aligner on one tooth may cause movement in another neighboring tooth, the outer aligner may be designed to reduce or eliminate this unwanted movement of the patient's neighboring tooth.
In various embodiments, the inner aligner is manufactured to include shaped features thereon, such as, but not limited to, dimples and/or ridges. Since the outer aligner is larger than the inner aligner, in many situations, there may be some gap area between the two aligners. This gap area can be filled by these shaped features, thereby enabling interactivity between the inner aligner and the outer aligner. As will be explained, with reference to
Various designs, orientations, and/or configurations of shaped features are available for use according to embodiments. Shaped features achieve force profiles favorable to specific types of tooth movement and can include both attachment-type features as well as non-attachment type features. Non-attachment type features can include various shaped alterations or protrusions in a surface of the dual aligner assembly, such as ridges (e.g., interior or exterior), dimples, and the like. The terms “non-attachment type feature” and “protrusion” (e.g., appliance protrusion) are typically used interchangeably herein. Dimples, for example, may be protrusions having substantially the same dimensions along a width compared to the protrusion length. Ridges, by comparison, for example, are protrusions having an unequal length and width. Interior protrusions, such as interior ridges, include a groove or protrusion in an inner aligner that recesses toward an inner surface (e.g., tooth contacting surface) of the inner aligner. Exterior protrusions and ridges bulge toward an exterior surface of the inner aligner system. Protrusion type features, such as dimples and ridges, can be either filled with material (e.g., composite material) or left unfilled. If it is filled, the composite can be controlled to solidify after the desired shape and/or volume of the filler is obtained. In the following discussion, the general term “feature” will be used. But the methods apply on any feature as appropriate.
In some instances, ridge-shaped protrusions may provide differences and/or advantages for an application of force to the patient's teeth compared to other protrusion shapes, such as dimples. For example, dimples having a substantially equal length compared to width will typically provide more of a point application of a force to a surface of a tooth. By comparison, a ridge-shaped protrusion may allow an application of force to be more evenly distributed along a surface of a tooth, and may provide more precisely controlled tooth movement in some instances. Further, ridge-shaped protrusions provide more protrusion configuration and design options, provide a greater range of force values that can be selected and delivered to the target tooth compared to non-ridge shapes (such as dimples), and can therefore be more likely to impart the desired load against the target tooth. As such, the use of ridges compared to other more simplified shapes (e.g., a single dimple) provide a greater range of available force values or selections for imparting the desired load vector, or force direction and/or magnitude along a tooth surface, thereby providing more treatment options.
As noted, various designs, orientations, and/or configurations of shaped features are available for use according to the present invention and can depend, at least partially, on the desired application of force and tooth movement. Exemplary designs/configurations of ridged protrusions are illustrated with reference to
As shown in
Any number of one or more shaped features can be included in design and fabrication of embodiments. In one embodiment, the gap between the inner aligner and the outer aligner can include a plurality of shaped features, such as protrusions. For example, the gap can include at least two shaped features, such as protrusions that are shaped and positioned within the cavity, such that each of the protrusions are brought into contact with the received patient's tooth when the dual aligner assembly is initially worn by the patient. Thus, a number of protrusions (e.g., two or more) can be configured and incorporated in the dual aligner assembly such that each of these protrusions will each engage the received tooth when the dual aligner assembly is initially worn by the patient and before the tooth has been moved by the appliance.
Besides protrusions or non-attachment type shaped features, the shaped features of the present invention can optionally include attachment type features. Attachment, as used herein, may be any form of material that may be attached to the tooth whether preformed, formed using a template or in an amorphous form that is attached to the surface of the tooth. It can be disposed on the tooth surface using an adhesive material, or the adhesive material itself may be disposed on the surface of the tooth as an attachment.
Generally, the attachments operate to provide “bumps” on a surface of the tooth which otherwise would be difficult for the dental appliance to grip. Attachments may also be engaged by the appliance in a manner that favors delivery of desired force directions and magnitudes. Attachments typically include a material bonded or attached to a surface of the tooth, with a corresponding receiving portion or couple built into the tooth receiving appliance. In one example, an attachment-type feature can include an orphan attachment, or any appropriate shaped material bonded to the crown surface, but with no receptacle or receiving portion build into the appliance to receive the attachment shape. Instead, the generated force concentrates on the contact area between the aligner surface and the attachment.
With reference to
With reference to
With reference to
With reference to
With reference to
With reference to
With reference to
Arch expansion is a frequently used technique to fix jaw crowding malocclusion. Arch expansion is done by moving posterior teeth (molars and premolars) in the buccal direction. With the use of conventional aligners, arch expansion may be difficult for several reasons.
Firstly, molars are bulky and are difficult to move by the conventional aligner system.
Secondly, since the conventional aligner is made from the same plastic film with uniform thickness, the force that is applied to posterior teeth is the same as the force applied to teeth other than the posterior teeth. Due to the same force being applied to different areas of the dental arch, the process of moving groups of teeth using the conventional aligner system is difficult.
Thirdly, there are difficulties moving the middle teeth of a group of teeth using the conventional aligner system. In general, conventional aligners are formed based on a group of teeth that are positioned in the next stage (i+1), so that there is no relative shape change for the teeth positioned in the middle of the group of teeth. With reference to
According to
As described herein, in some embodiments, the dual aligner assembly includes an inner aligner, an outer aligner, and one or more intermediate aligners for being positioned between the inner aligner and the outer aligner. For example, in one embodiment, a dual aligner assembly includes a plurality of aligners. The plurality of aligners includes a first aligner and a second aligner. The first aligner includes a first material having a first shape corresponding to a first set of target tooth positions, wherein the first aligner applies a first orthodontic force against a set of target teeth of a plurality of teeth of a dental arch of a patient, wherein the first orthodontic force generates movement of the set of target teeth to the first set of target tooth positions. The second aligner includes a second material having a second shape corresponding to a combination of current tooth positions of the set of target teeth, the first set of target tooth positions, at least a second set of target tooth positions, and a thickness of at least the first aligner. According to some embodiments, there exists an intermediate aligner in between the first aligner and the second aligner. The intermediate aligner is formed based on a second set of target tooth positions that is different from the first set of target tooth positions. The second aligner, in turn, accommodates not only the first set of target tooth positions considered by the first aligner, but one or more other sets of target tooth positions considered by the one or more intermediate aligners. The second aligner also accommodates the thicknesses of the first aligner and any intermediate aligner.
According to an embodiment, the second aligner partially encloses at least the first aligner (as well as any intermediate aligners) and provides an anchor for at least a portion of at least the first aligner (and any intermediate aligners). Via the anchorage (the principal of operation of which is described herein), a combination of the first aligner and the second aligner and any intermediate aligner positioned between the first aligner and the second aligner provide a second orthodontic force that prevents the set of target teeth from moving to unwanted tooth positions during orthodontic treatment.
The term, “unwanted tooth positions”, includes tooth positions other than the following tooth positions: the current tooth positions of the set of target teeth; one or more tooth positions that represent movement of at least one tooth of the set of target teeth to any set of target tooth positions (including the first set of target tooth positions and at least a second set of target tooth positions); and any set of target tooth positions (including the first set of target tooth positions and at least a second set of target tooth positions).
Each of the inner aligners of the multiple aligners, in various embodiments, may include inward and/or outward protrusions (e.g., dimples, ridges, etc.), the operation of which are described herein.
Thus, in some embodiments, the dual aligner assembly includes three or more aligners which are combined to provide more exact and desired forces directed toward a predetermined tooth/teeth, in order to provide a more efficient and accurate orthodontic process.
In general, the steps of manufacturing the dual aligner assembly include the following: 1) Create a mold of the jaw with the patient's teeth positioned in the next stage position. 2) Use a vacuum thermoforming process to create the inner aligner from the mold. 3) Create a combined model of the patient's teeth, in the current stage and the next position. Then, inflate the model with a thickness of the inner aligner thickness. 4) Create a mold of a combined jaw model, using a vacuum thermoforming process to create the outer aligner from the mold. 5) Snap the inner model into the outer aligner to create the “dual aligner assembly”.
The outer aligner is made from the combination of teeth from the current position of the patient's teeth (i) and the desired next stage position (i+1) of the patient's teeth. According to an embodiment, the manufacture of the outer aligner is different from the conventional manufacture of an aligner for the patient's teeth in the current position of the teeth as well as different from the conventional manufacture of a single aligner. Further, the manufacture of the outer aligner, according to embodiments, is different from the manufacture of the inner aligner of the dual aligner assembly.
A more detailed description of process for manufacturing the outer aligner is as follows.
To create the outer aligner, the first step is building a 3D solid model to combine the teeth in two positions, as well as accommodating the thickness of the inner aligner. The process to create the 3D solid model includes the following:
1) For each of the patient's teeth, based on the tooth's next position, create a next position 3D tooth model.
2) Offset the next position 3D tooth model's surface by the inner aligner's thickness to create an offset 3D tooth model.
3) For each of the patient's teeth, based on the tooth's current position, create a current 3D tooth model.
4) For each of the patient's teeth, create a 0-N intermediate position(s). Based on the intermediate position(s), create a 0-N intermediate 3D model(s).
5) Through applying union Boolean operation on the offset 3D tooth model, current 3D tooth model and 0-N intermediate 3D tooth model(s), create a combined tooth 3D model.
6) Through applying the union Boolean operation on all the teeth (on a jaw) combined 3D models and the jaw's gingival model, create a jaw mold's 3D model, which is used for forming an outer aligner.
In the process described above, the current tooth position and the next tooth position are used to create an outer aligner's mold model. Between the current tooth position and the next tooth position, one more intermediate tooth positions may be added to create intermediate 3D tooth models. To create combined tooth 3D models, the union Boolean operation is applied to an offset tooth model, to a current tooth model and to an intermediate tooth model(s). By introducing the intermediate tooth model(s), the tooth movement is more guided from its current position to the next position and the aligner surface has smoother transitions.
Referring now to
It should be noted that any of the features disclosed herein may be useful alone or in any suitable combination. While the foregoing is directed to embodiments of the present invention, other and further embodiments of the invention may be implemented without departing from the scope of the invention, and the scope thereof is determined by the claims that follow.
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